CULTURAL COMPETENCY IN FOOD ALLERGY: NEW FROG ALLERGY IN KNOWN FISH ALLERGIC PATIENT

Abstract

<h3>Introduction</h3> Allergic reactions in response to consumption of frog are rare. In this case, we describe a patient with a previously diagnosed fish allergy that experienced an allergic reaction after consumption of frog meat. <h3>Case Description</h3> A 23-year-old female with allergic phenotype and fish allergy presented with a concern for frog allergy. Immediately after tasting frog legs, the patient experienced lip swelling and throat itching sensation. She promptly took Benadryl and symptoms resolved. Her previous history includes multiple episodes of anaphylaxis to fish involving throat swelling, hives, and vomiting requiring epinephrine. <h3>Discussion</h3> The possibility of concomitant allergy to fish and frog meat has been documented due to the presence of IgE cross reactivity of frog and fish parvalbumin, due to similarities in amino acid sequencing up to 70% between frog and various fish species. While fish allergy is well known, worldwide incidence of allergy to frog, particularly in individuals with allergy to fish, is not clearly defined. While most ingestion of frog legs occurs in Europe and East Asia and is best known for being a delicacy in French cuisine, frog meat is eaten in the Southern United States, especially in areas of historical French influence. This may impact regional counseling of patients with severe fish allergy and present an uncommon cause of anaphylaxis in fish allergic patients. Our patient highlights the importance of considering the possibility of IgE cross reactivity of frog and fish in a known fish allergic patient whose cultural diet may include frog meat.